Effect of Epidural Ketamine Combined with Bupivacaine and Meperidine on Postoperative Pain and Analgesic Consumption after Cesarean Section. |
Hae Jin Lee, Choon Ho Sung |
Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea. |
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Abstract |
BACKGROUND Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist with analgesic properties. This study was undertaken to evaluate the potential utility of epidural ketamine combined with meperidine and bupivacaine for postoperative patient-controlled epidural analgesia (PCEA) after cesarean section. METHODS Forty-five patients received epidural catheterization in the L3-4 intervetebral space and underwent cesarean section under epidural anesthesia. In the recovery room, these patients were randomly allocated to 3 groups; group I (control; n = 15) received 1 mg/ml bupivacaine and 1 mg/ml meperidine, group II (n = 15) received 1 mg/ml bupivacaine and 1 mg/ml meperidine with 0.25 mg/ml ketamine, group III (n = 14) received 1 mg/ml bupivacaine and 1 mg/ml meperidine with 0.75 mg/ml ketamine using a PCEA device for postoperative pain control. The analgesic effects and PCEA consumption were assessed at 6, and 24 hours after surgery. Side effects were also evaluated. RESULTS There were no statistically significant differences in the visual analogue scale for pain, the consumption of the analgesics and side effects among the groups. CONCLUSIONS Epidural ketamine combined with bupivacaine and meperidine did not improve postoperative analgesia, nor did it reduce consumption of the analgesics and side effects. |
Key Words:
Analgesia: epidural; patient-controlled; Analgesics: bupivacaine; ketamine; meperidine; Pain: postoperative |
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